Efficacy and safety of pulse immunosuppressive therapy with glucocorticoid and cyclophosphamide in patients with paraquat poisoning: A meta-analysis

He, Fei; Xu, Peng; Zhang, Jun; Zhang, Qiuling; Gu, Shuangshuang; Liu, Yao; Wang, Jun

doi:10.1016/j.intimp.2015.04.030

Cited by 15 publications

(18 citation statements)

References 15 publications

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“…Similar survival benefits were also noted in the meta analysis by He et al [8] The beneficial effect of combination of immunosuppressive with haemoperfusion and their survival benefits have also been addressed earlier. In the nationwide analysis by Wu et al, the addition of immunosuppressive therapy to Haemoperfusion for paraquat poisoning increased the survival rate from 24.2% to 29.3%.…”

Section: Discussionsupporting

confidence: 76%

The Role of Early Haemoperfusion/Haemodialysis With Steroids, Cyclophosphamide, N Acetyl Cysteine and Everolimus in Acute Paraquat Poisoning: Is There Still Hope?

Waikhom¹,

Vedanti²,

Iboton³

et al. 2016

jemds

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Section: Discussionsupporting

confidence: 76%

The Role of Early Haemoperfusion/Haemodialysis With Steroids, Cyclophosphamide, N Acetyl Cysteine and Everolimus in Acute Paraquat Poisoning: Is There Still Hope?

Waikhom¹,

Vedanti²,

Iboton³

et al. 2016

jemds

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“…Current treatments for PQ poisoning primarily consist of anti-inflammatory and anti-oxidative treatments for the attenuation of PQ-induced ALI (25,26). However, the effectiveness of such treatments has been contested (12,27). Therefore, further investigation for a suitable and effective treatment is required to improve therapeutic outcomes for PQ-induced ALI.…”

Section: Discussionmentioning

confidence: 99%

Tanshinone IIA attenuates paraquat‑induced acute lung injury by modulating angiotensin‑converting enzyme 2/angiotensin‑(1‑7) in rats

Wang

Niu

et al. 2018

Mol Med Report

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Tanshinone IIA (TIIA) is an active compound that can be isolated from the Chinese herb, Salvia miltiorrhizae Bunge, also known as danshen. Previous studies have demonstrated that TIIA can effectively attenuate bleomycin‑induced pulmonary fibrosis in rats. However, it has not been determined whether TIIA can attenuate paraquat (PQ)‑induced acute lung injury (ALI). In the present study, the protective effects exhibited by TIIA on PQ‑induced ALI, as well as its underlying mechanisms, were investigated using Sprague‑Dawley (SD) rats. ALI animal models using rats were established via administration of PQ. Adult male SD rats were randomly divided into three groups: A control group, a PQ group and a PQ + TIIA group. Total cell count, total protein levels and lactic dehydrogenase (LDH) levels in bronchoalveolar lavage fluid (BALF), as well as myeloperoxidase (MPO) activity in lung tissues were determined. Lung histological alterations were also investigated. Angiotensin converting enzyme 2 (ACE2) and Angiotensin 1‑7 [Ang‑(1‑7)] expression levels in the lung were also analyzed. The results demonstrated that administration of PQ induced marked histological alterations, and markedly increased neutrophil infiltration, lung wet/dry weight ratio, total cell count, protein content and LDH levels in BALF. In addition, PQ was revealed to significantly decrease ACE2 and Ang‑(1‑7) expression levels in lung tissues. However, it was demonstrated that TIIA attenuated these effects. Therefore, the results of the present study suggest that that TIIA may exhibit a therapeutic effect regarding PQ‑induced ALI in rats, and that ACE2 and Ang‑(1‑7) may be involved in the underlying mechanisms of this effect.

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“…Earlier studies [14–16] involved a dexamethasone administration of 24 mg day –1 for 2 weeks, followed by 1.5 mg day –1 for another 2 weeks; whereas an MP administration of 1 g kg –1 for 3 days, followed by dexamethasone 1.5-30 mg day –1 for 1 to 2 weeks, [4,17,18] is currently recommended for PQ intoxication. A recent meta-analysis [19] confirmed that the pulse therapy with a MP dose of 1 g for 3 days is safe and well-tolerated. In addition, some recent trials [3,9] showed a novel method: initial pulse therapy with methylprednisolone (MP) (1 g day –1 for 3 days), then dexamethasone 20 mg day –1 until PaO 2 was 80 mm Hg, and repeated pulse therapy with MP (1 g day –1 for 3 days), which was repeated if PaO 2 was <60 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

Prolonged methylprednisolone therapy after the pulse treatment for patients with moderate-to-severe paraquat poisoning

et al. 2017

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This retrospective study aims to evaluate the effect of prolonged methylprednisolone (MP) therapy on the mortality of patients with moderate-to-severe paraquat (PQ) poisoning after the pulse treatment.We performed a retrospective analysis of patients with acute moderate-to-severe PQ poisoning that were admitted to the emergency department from May 2012 to August 2016. Out of 138 patients, 60 were treated with pulse treatment (15 mg kg–1 day–1 MP for 3 days) and 78 were treated with prolonged MP therapy after pulse treatment (15 mg kg–1 day–1 MP for 3 days; afterward, the dosage was reduced in half every 2 days, and the MP therapy was terminated until 0.47 mg kg–1 day–1). Kaplan–Meier method was used to compare the mortality between the 2 groups. Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).The mortality of the prolonged MP therapy after pulse treatment group was lower than that of the pulse group (47.4% vs 63.3%; log-rank tests, P = .003). According to the multivariate Cox analysis, the prolonged MP therapy after pulse treatment was significantly associated with a lower mortality risk (HR: 0.31, 95% CI: 0.19–0.52, P < .001) compared with the pulse group. In addition, the prolonged MP therapy after pulse treatment caused more incidences of leucopenia than the pulse treatment alone (25.6% vs 11.7%, P = .04).The prolonged MP therapy after pulse treatment can reduce the mortality of moderate-to-severe PQ poisoning patients.

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Efficacy and safety of pulse immunosuppressive therapy with glucocorticoid and cyclophosphamide in patients with paraquat poisoning: A meta-analysis

Cited by 15 publications

References 15 publications

The Role of Early Haemoperfusion/Haemodialysis With Steroids, Cyclophosphamide, N Acetyl Cysteine and Everolimus in Acute Paraquat Poisoning: Is There Still Hope?

The Role of Early Haemoperfusion/Haemodialysis With Steroids, Cyclophosphamide, N Acetyl Cysteine and Everolimus in Acute Paraquat Poisoning: Is There Still Hope?

Tanshinone IIA attenuates paraquat‑induced acute lung injury by modulating angiotensin‑converting enzyme 2/angiotensin‑(1‑7) in rats

Prolonged methylprednisolone therapy after the pulse treatment for patients with moderate-to-severe paraquat poisoning

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